Provider Demographics
NPI:1245704014
Name:ARLEDGE, ANDREA OWEN (CHN, RN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:OWEN
Last Name:ARLEDGE
Suffix:
Gender:F
Credentials:CHN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-6619
Mailing Address - Country:US
Mailing Address - Phone:864-979-0828
Mailing Address - Fax:
Practice Address - Street 1:8 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-6619
Practice Address - Country:US
Practice Address - Phone:864-979-0828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education